Allergic Rhinitis Greatly Raises Long-Term Risk of Repeat Adenoidectomy: Study Finds
USA: Researchers have found in a new study that children with allergic rhinitis showed no early difference in secondary adenoidectomy rates within 6 months after surgery, but from 6 months onward, they had a significantly higher risk, persisting up to 7+ years. This indicates that allergic rhinitis markedly increases the long-term likelihood of requiring a repeat adenoidectomy.
The findings were published in the International Journal of Pediatric Otorhinolaryngology by Sofia Piperno and colleagues from the John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Adenoidectomy, one of the most common outpatient surgical procedures in children, involves removing the adenoids, lymphoid tissues located in the nasopharynx. Allergic rhinitis, a prevalent condition in pediatric populations, is known to contribute to adenoid hypertrophy. Over time, enlarged adenoids can cause persistent symptoms, potentially necessitating a secondary procedure. The study aimed to evaluate how the presence of allergic rhinitis influences the need for repeat adenoidectomy across different time intervals following the initial surgery.
The researchers analyzed data from 65,106 patients using the TriNetX research network. Children with allergic rhinitis who had undergone a primary adenoidectomy were compared to a matched control group of patients without allergic rhinitis. Propensity score matching ensured that the cohorts were balanced in terms of demographics and other baseline characteristics.
The study then examined rates of secondary adenoidectomy across several intervals: 0–0.5 years, 0.5–1 year, 1–2 years, 2–3 years, 3–4 years, 4–5 years, 5–7 years, and beyond 7 years after the initial procedure.
The analysis led to the following findings:
- No significant difference in secondary adenoidectomy rates was observed between children with and without allergic rhinitis within the first 6 months after surgery.
- Starting from 6 months post-surgery, children with allergic rhinitis had a higher risk of requiring revision adenoidectomy.
- Statistically significant increased risk was observed at 0.5–1 year.
- Higher risk persisted at 1–2 years.
- Elevated risk continued at 2–3 years.
- The trend remained at 3–4 years.
- Increased risk was noted at 4–5 years.
- Significant risk persisted at 5–7 years.
- A higher likelihood of secondary adenoidectomy was also observed beyond 7 years.
These findings highlight that allergic rhinitis has a long-term impact on adenoid regrowth and the likelihood of subsequent surgery.
The authors highlighted that while previous research has identified allergic rhinitis as a risk factor for revision adenoidectomy, few studies have analyzed how this risk evolves over time. “This is the first study to stratify secondary adenoidectomy rates across multiple postoperative intervals specifically for patients with allergic rhinitis,” they noted.
The study emphasizes the importance of ongoing management of allergic symptoms even after primary adenoidectomy. Long-term monitoring and treatment of allergic rhinitis may help reduce the need for revision surgery and improve overall outcomes for pediatric patients.
"Children diagnosed with allergic rhinitis are more likely to require a secondary adenoidectomy after the first 6 months post-surgery. Clinicians are encouraged to provide extended follow-up care and proactive management of allergic symptoms to potentially minimize the need for repeat procedures," the authors concluded.
Reference:
Piperno, S., Archer, T., Archer, S., McCarthy, E., Clark, D. E., Quinlan, B. P., & Pine, H. (2025). Patients with allergic rhinitis are more likely to need a secondary adenoidectomy after 6 months. International Journal of Pediatric Otorhinolaryngology, 199, 112646. https://doi.org/10.1016/j.ijporl.2025.112646
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